Journal article
Neural dysfunction and retinopathy in persons with type 1 diabetes
Ophthalmic epidemiology, Vol.25(5-6), pp.373-378
11/02/2018
DOI: 10.1080/09286586.2018.1489971
PMCID: PMC6411294
PMID: 29985712
Abstract
Objective: To determine associations of microvascular and neuropathic complications of diabetes cross-sectionally and longitudinally in persons with long-term type 1 diabetes (T1D).
Research Design and Methods: Persons receiving care for T1D in South Central Wisconsin were identified in 1979-1980 and examined approximately every 5 years. Associations between neuropathic and microvascular complications were examined at most prior visits, when information on several neuropathic complications was collected. Temporal relationships were examined by modeling incidence between examinations across the visits.
Results: Adjusting for duration of diabetes, glycated hemoglobin, and systolic blood pressure, the following were cross-sectionally associated with prevalent PDR (proliferative diabetic retinopathy): the presence of sensory neuropathy (SN) as reported at each Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) examination (odds ratio (OR) = 2.76, confidence interval (CI) = 1.71, 4.48) and the heartrate variability measures RMSD (square root of the mean of squared differences of successive RR intervals) (OR = 0.24, CI = 0.16, 0.37) and SDNN (standard deviation of successive RR intervals) (OR = 0.26, CI = 0.17, 0.39). Findings were similar for prevalent ME (macular edema) as assessed from spectral-domain optical coherence tomography (SD-OCT). The presence of PDR (OR = 2.13, CI = 1.63, 2.78) and ME (OR = 2.36, CI = 1.66, 3.34) were both significantly associated with incident WESDR SN. WESDR SN was associated with incident PDR (OR = 1.53, CI = 1.09, 2.15) but not incident ME (OR = 1.31, CI = 0.92, 1.87).
Conclusions: Sensory neuropathy and heartrate variability were significantly associated with prevalent PDR and ME in people with long-term T1D. PDR and ME were significantly associated with incident sensory neuropathy, and sensory neuropathy was significantly associated with incident PDR. Studies using earliest detectable markers of microvascular and neurologic abnormalities are needed to determine which of the two systems 'fails' first. Such information might suggest a temporal sequence of diabetes complications.
Details
- Title: Subtitle
- Neural dysfunction and retinopathy in persons with type 1 diabetes
- Creators
- Barbara E. K Klein - Ophthalmology & Visual Sciences, University of Wisconsin-MadisonKayla L Horak - Ophthalmology & Visual Sciences, University of Wisconsin-MadisonKristine E Lee - Ophthalmology & Visual Sciences, University of Wisconsin-MadisonStacy M Meuer - Ophthalmology & Visual Sciences, University of Wisconsin-MadisonMichael D Abramoff - Biomedical Engineering, University of IowaElsayed Z Soliman - Epidemiology & Prevention EpiCare, Wake Forest UniversityMary Rechek - Ophthalmology & Visual Sciences, University of Wisconsin-MadisonRonald Klein - Ophthalmology & Visual Sciences, University of Wisconsin-Madison
- Resource Type
- Journal article
- Publication Details
- Ophthalmic epidemiology, Vol.25(5-6), pp.373-378
- DOI
- 10.1080/09286586.2018.1489971
- PMID
- 29985712
- PMCID
- PMC6411294
- NLM abbreviation
- Ophthalmic Epidemiol
- ISSN
- 0928-6586
- eISSN
- 1744-5086
- Publisher
- Taylor & Francis
- Grant note
- National Institutes of Health (10.13039/100000002)
- Language
- English
- Date published
- 11/02/2018
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Electrical and Computer Engineering; Fraternal Order of Eagles Diabetes Research Center; Ophthalmology and Visual Sciences
- Record Identifier
- 9984060715202771
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